| NPI | 1619993185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA01091) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60693484) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2025-09-25 |